| NPI | 1336113604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35-096132) |
| Additional Taxonomies | 208800000X Urology (Licence: IN 01061364A) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-01-07 |